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Interpretation of Fetal Heart Tracings
Jan 11, 2015
•
Mark Morgan
categories:
Obstetrics
Interpretation of Fetal Heart Tracings
VARIABILITY
Fluctuations in baseline that are irregular in amplitude and frequency. Measured in a 10 minute window. Amplitude is measured peak to trough.
Finding -->
Absent - amplitude undetectable
Minimal - amplitude 0 to 5 bpm
Moderate - amplitude 6 to 25 bpm
Marked - amplitude over 25 bpm
BASELINE RATE
Mean bpm (rounded to 0 or 5) over a 10 minute interval, excluding periodic changes, periods of marked variability, and segments that differ by more than 25 bpm. The baseline must be identifiable for 2 minutes during the interval (but not necessarily a contiguous 2 minutes), otherwise it is considered indeterminate.
Finding -->
bpm
ACCELERATION
An abrupt (less than 30 seconds) increase in the fetal heart rate. Before 32 weeks gestation, accelerations should last 10 or more seconds and peak 10 or more bpm above baseline. After 32 weeks gestation, accelerations should last 15 or more seconds and peak 15 or more bpm above baseline. A prolonged acceleration is 2 or more minutes, but less than 10 minutes. An acceleration of 10 minutes or more is considered a change in baseline.
Finding -->
accelerations
LATE DECELERATION
A gradual (30+ seconds) decrease and return to baseline of the fetal heart rate associated with a uterine contraction. The nadir of the deceleration occurs after the peak of the contraction.
Finding -->
late decelerations
EARLY DECELERATION
A gradual (30+ seconds) decrease and return to baseline of the fetal heart rate associated with a uterine contraction. The nadir of the deceleration and the peak of the contraction occur at the same time.
Finding -->
early decelerations
VARIABLE DECELERATION
An abrupt (less than 30 seconds) decrease in the fetal heart rate below the baseline. The decrease is at least 15 bpm lasting between 15 seconds and 2 minutes from onset to return to baseline.
Finding -->
variable decelerations
CONTRACTIONS
Finding -->
Present
Absent
Frequency --> Every
minutes
Rhythm -->
Regular
Irregular
-------------------------------------------------------------------------------------------------------
INTERPRETATION -->
Reassuring
Non-Reassuring
Ominous
show interpretation suggestions
INTERPRETATION SUGGESTIONS from FPNotebook.com
FPNotebook.com
Reassuring
.. Normal baseline (120-160)
.. Moderate Fetal Bradycardia (100-120), good variability
.. Good beat-to-beat variability (short term variability)
.. Accelerations
.... Heart Rate increases by 15-25 bpm over baseline
.... Increase persists for 15-25 seconds
.. Early Decelerations
.... Suggests head compression with contraction
.. Mild Variable Decelerations
Non-Reassuring
.. Fetal Tachycardia (>160)
.. Moderate Fetal Bradycardia (100-120), lost variability
.. Absent beat-to-beat variability (short term variability)
.. Marked Fetal Bradycardia (90-100 bpm)
.. Moderate Variable Decelerations
.. Variable Decelerations
.. Early Decelerations and slow return baseline
Ominous
.. Fetal Tachycardia with loss of variability
.. Prolonged marked Fetal Bradycardia (<90 bpm)
.. Late Decelerations
.. Severe Variable Decelerations
.... Fetal Heart Rate drops below 70 beats per minute
.... Deceleration persists for 1 minute or more
display/hide references
reference:
#1
Macones GA, Hankins GD, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol. 2008 Sep;112(3):661-6.
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